• N C Buchs, B Konrad-Mugnier, A-S Jannot, P-A Poletti, P Ambrosetti, and P Gervaz.
• Department of Surgery, Geneva University Hospital and Medical School, Geneva, Switzerland.
• Br J Surg. 2013 Jun 1; 100 (7): 976-9; discussion 979.

BackgroundThe natural history of sigmoid diverticulitis has been inferred from population-based or retrospective studies. This study assessed the risk of a recurrent attack following the first episode of uncomplicated diverticulitis.MethodsPatients admitted between January 2007 and December 2011 with a first episode of uncomplicated sigmoid diverticulitis confirmed on computed tomography were enrolled in this prospective study. After successful medical management of the first episode, follow-up was conducted through yearly telephone interviews. Cox proportional hazards regression was performed to model the impact of various parameters on eventual recurrences and complications.ResultsDuring a median follow-up of 24 (range 3-63) months, 46 (16·4 per cent) of 280 patients experienced a second episode of diverticulitis. Six patients (2·1 per cent) subsequently developed complicated diverticulitis and four (1·4 per cent) underwent emergency surgery for peritonitis. In multivariable analysis, a raised serum level of C-reactive protein (over 240 mg/l) during the first attack was associated with early recurrence (hazard ratio 1·75, 95 per cent confidence interval 1·04 to 2·94; P = 0·035).ConclusionUncomplicated sigmoid diverticulitis follows a benign course with few recurrences and little need for emergency surgery.Registration NumberNCT01015378 (http://www.clinicaltrials.gov).© 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

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